Symptom persistence after vascular ring repair in children

Area of Science:

• Pediatric Surgery
• Cardiovascular Surgery
• Congenital Heart Disease

Background:

• Vascular rings, congenital anomalies of the aortic arch, often present with dysphagia and respiratory distress.
• Symptom resolution after surgical repair of vascular rings is not fully characterized.
• Limited data exists on the long-term outcomes and persistent symptoms following vascular ring repair.

Purpose of the Study:

• To evaluate the persistence of pre-operative symptoms after open vascular ring repair.
• To assess the safety and efficacy of surgical intervention for vascular rings.
• To identify factors associated with post-operative symptoms in patients with vascular rings.

Main Methods:

• Retrospective chart review of 63 patients undergoing open vascular ring repair (July 2007-May 2018).
• Data collection included vascular anatomy, demographics, pre- and post-operative symptoms, and chromosomal abnormalities.
• Patient families completed a symptom-focused survey for post-operative assessment.

Main Results:

• No operative mortality; re-exploration for chylothorax (3) and late aortopexy (3) were noted.
• Significant rates of post-operative symptoms persisted: 45% in single aberrant subclavian artery (SAA) and 65% in double aortic arch (DAA) cases.
• Survey data indicated persistent breathing and swallowing difficulties in a subset of patients.

Conclusions:

• Open repair of vascular rings is a safe procedure with low mortality.
• A substantial proportion of patients experience persistent symptoms after vascular ring repair, warranting further investigation.
• The long-term impact of vascular rings on patient symptomatology requires additional study.